Author + information
- Received December 6, 2010
- Revision received February 23, 2011
- Accepted March 5, 2011
- Published online June 1, 2011.
- Benjamin R. Plaisance, MD⁎,†,
- Khan Munir, PhD⁎,
- David A. Share, MD, MPH‡,
- M. Ashraf Mansour, MD§,
- James M. Fox, MD∥,
- Paul G. Bove, MD¶,
- Arthur L. Riba, MD#,
- Stanley J. Chetcuti, MD⁎,†,
- Hitinder S. Gurm, MD⁎,†,
- P. Michael Grossman, MD⁎,†,⁎ (, )
- BMC2 PVI (Blue Cross Blue Shield of Michigan Cardiovascular Consortium Peripheral Vascular Intervention)
- ↵⁎Reprint requests and correspondence:
Dr. P. Michael Grossman, University of Michigan Hospitals and Health Systems, Veterans Administration, Ann Arbor Healthcare System, 1500 East Medical Center Drive, South Pacific Commission 5869, Ann Arbor, Michigan 48109-5869
Objectives This study sought to evaluate the effect of age on procedure type, periprocedural management, and in-hospital outcomes of patients undergoing lower-extremity (LE) peripheral vascular intervention (PVI).
Background Surgical therapy of peripheral arterial disease is associated with significant morbidity and mortality in the elderly. There are limited data related to the influence of advanced age on the outcome of patients undergoing percutaneous LE PVI.
Methods Clinical presentation, comorbidities, and in-hospital outcomes of patients undergoing LE PVI in a multicenter, multidisciplinary registry were compared between 3 age groups: <70 years, between 70 and 80 years, and ≥80 years (elderly group).
Results In our cohort, 7,769 patients underwent LE PVI. The elderly patients were more likely to be female and to have a greater burden of comorbidities. Procedural success was lower in the elderly group (74.2% for age ≥80 years vs. 78% for age 70 to <80 years and 81.4% in patients age <70 years, respectively; p < 0.0001). Unadjusted rates of procedure-related vascular access complications, post-procedure transfusion, contrast-induced nephropathy, amputation, and major adverse cardiac events were higher in elderly patients. After adjustment for baseline covariates, the elderly patients were more likely to experience vascular access complications; however, advanced age was not found to be associated with major adverse cardiac events, transfusion, contrast-induced nephropathy, or amputation.
Conclusions Contemporary PVI can be performed in elderly patients with high procedural and technical success with low rates of periprocedural complications including mortality. These findings may support the notion of using PVI as a preferred revascularization strategy in the treatment of severe peripheral arterial disease in the elderly population.
The work is supported by an unrestricted grant from Blue Cross Blue Shield of Michigan. Dr. Share is supported by Blue Cross Blue Shield of Michigan. Dr. Bove has received research support from Medtronic, Cook Medical, Gore Medical, Endologix, Cordis, and ev3. Dr. Gurm is supported by Blue Cross Blue Shield of Michigan and the National Institutes of Health. Dr. Grossman is supported by Blue Cross Blue Shield of Michigan and the National Institutes of Health. All other authors have reported that they have no relationships to disclose.
- Received December 6, 2010.
- Revision received February 23, 2011.
- Accepted March 5, 2011.
- American College of Cardiology Foundation